Radio-immunotherapy and chemo-immunotherapy as a novel treatment paradigm in malignant pleural mesothelioma

Wu, Licun; Perrot, Marc de

doi:10.21037/tlcr.2017.06.03

Cited by 21 publications

(18 citation statements)

References 44 publications

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“…In fact, other systemic or intrapleural alternatives have been under investigation by different working groups (22)(23)(24)(25)(26). Immunotherapy, in the form of immune checkpoint blockade, immunotoxin therapy, anticancer vaccines, oncolytic viral therapy, and adoptive cell therapy are the most common methods of immunotherapy currently being used in the clinical setting (22).…”

Section: Discussionmentioning

confidence: 99%

“…Immunotherapy can also be associated with radiotherapy [including intensity modulated radiation therapy (IMRT)] and chemotherapy (23,24). The potential benefit of short course high dose radiation on the immune system has been reported, and that could be the rationale for the combination of the two modality treatments (23).…”

Section: Discussionmentioning

confidence: 99%

“…The potential benefit of short course high dose radiation on the immune system has been reported, and that could be the rationale for the combination of the two modality treatments (23). On the other hand, some chemotherapeutic drugs have been shown to induce cell death and therefore can stimulate an immune response against tumor cells (23)(24)(25). Some years ago, we assessed the effect of intrapleural immuno-chemotherapy on the extent of local tumor recurrence in an established rat model of MPM (6).…”

Section: Discussionmentioning

confidence: 99%

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Polymeric films loaded with cisplatin for malignant pleural mesothelioma: a pharmacokinetic study in an ovine model

et al. 2018

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Background: Malignant pleural mesothelioma (MPM) continues to be a distressing tumor due to its aggressive biologic behavior and scanty prognosis. Several therapeutic approaches have been tested both in clinical and preclinical settings, being intrapleural chemotherapy one of the most promising. Some years ago, our interest focused on polymeric films loaded with cisplatin for the adjuvant intrapleural treatment of surgical patients. After in vitro and in vivo studies in a rat recurrence model of MPM, the aim of this study Results: Twenty female Sardinian sheep with a mean weight of 45.1 kg were studied. All animals survived the surgical procedures. The whole surgical procedure had a mean duration of 113 minutes. Cisplatin blood levels obtained from polymeric films application were low during the first 24 hours after the application; then, the cisplatin blood level increased gradually and progressively until it reached significantly higher plasmatic concentrations after 120 hours compared to intrapleural cisplatin solution (P=0.004) and intravenous administration (P=0.001), respectively. Considering cisplatin concentration at 168 hours after the application, animals treated with polymeric films had higher plasmatic values than animals treated with intrapleural cisplatin solution and intravenous cisplatin (P=0.001). Despite the high cisplatin plasmatic concentrations, treatment related-toxicity towards kidneys and liver was comparatively lower compared to the intravenous and intrapleural cisplatin administration and closer to the control levels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Polymeric films loaded with cisplatin for malignant pleural mesothelioma: a pharmacokinetic study in an ovine model

et al. 2018

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“…As for other cancer types, immunotherapy is opening new options for the treatment of MPM. Clinical trials with dendritic cells and live-attenuated Listeria vaccination have produced encouraging results and are being considered for multicenter phase II trials ( 165 ). Intrapleural injection of oncolytic viruses (herpesvirus, poxvirus, adenovirus, and several attenuated RNA viruses) has also been considered as a possible treatment for unresectable MPM, due to the sensibility of MPM cells to their action, by direct killing or by immune-mediated mechanisms ( 166 ).…”

Section: Current Therapeutic Approaches To Mpmmentioning

confidence: 99%

New Perspectives on Diagnosis and Therapy of Malignant Pleural Mesothelioma

et al. 2018

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Malignant pleural mesothelioma (MPM) is a rare, but severe form of cancer, with an incidence that varies significantly within and among different countries around the world. It develops in about one to two persons per million of the general population, leading to thousands of deaths every year worldwide. To date, the MPM is mostly associated with occupational asbestos exposure. Asbestos represents the predominant etiological factor, with approximately 70% of cases of MPM with well-documented occupational exposure to asbestos, with the exposure time, on average greater than 40 years. Environmental exposure to asbestos is increasingly becoming recognized as a cause of mesothelioma, together with gene mutations. The possible roles of other cofactors, such as viral infection and radiation exposure, are still debated. MPM is a fatal tumor. This cancer arises during its early phase without clinical signs. Consequently, its diagnosis occurs at advanced stages. Standard clinical therapeutic approaches include surgery, chemo- and radiotherapies. Preclinical and clinical researches are making great strides in the field of this deadly disease, identifying new biomarkers and innovative therapeutic approaches. Among the newly identified markers and potential therapeutic targets, circulating microRNAs and the Notch pathway represent promising avenues that could result in the early detection of the tumor and novel therapeutic approaches.

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“…However, since 80% of patients are diagnosed in stage III/IV, they are not candidates for surgical cure because their disease is no longer resectable [ 4 ]. Some hope lies in the recent advancement of intensity-modulated radiotherapy (IMRT), which precisely delivers radiation doses to the malignant tissues, while sparing normal counterparts [ 5 ]. Unfortunately, because of its low radio- and chemo-sensitivity, MPM remains unresponsive to systemic therapy.…”

Section: Introductionmentioning

confidence: 99%

Heterogeneous Contributing Factors in MPM Disease Development and Progression: Biological Advances and Clinical Implications

Tolani

Acevedo

Hoang

et al. 2018

IJMS

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Malignant pleural mesothelioma (MPM) tumors are remarkably aggressive and most patients only survive for 5–12 months; irrespective of stage; after primary symptoms appear. Compounding matters is that MPM remains unresponsive to conventional standards of care; including radiation and chemotherapy. Currently; instead of relying on molecular signatures and histological typing; MPM treatment options are guided by clinical stage and patient characteristics because the mechanism of carcinogenesis has not been fully elucidated; although about 80% of cases can be linked to asbestos exposure. Several molecular pathways have been implicated in the MPM tumor microenvironment; such as angiogenesis; apoptosis; cell-cycle regulation and several growth factor-related pathways predicted to be amenable to therapeutic intervention. Furthermore, the availability of genomic data has improved our understanding of the pathobiology of MPM. The MPM genomic landscape is dominated by inactivating mutations in several tumor suppressor genes; such as CDKN2A; BAP1 and NF2. Given the complex heterogeneity of the tumor microenvironment in MPM; a better understanding of the interplay between stromal; endothelial and immune cells at the molecular level is required; to chaperone the development of improved personalized therapeutics. Many recent advances at the molecular level have been reported and several exciting new treatment options are under investigation. Here; we review the challenges and the most up-to-date biological advances in MPM pertaining to the molecular pathways implicated; progress at the genomic level; immunological progression of this fatal disease; and its link with developmental cell pathways; with an emphasis on prognostic and therapeutic treatment strategies.

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Radio-immunotherapy and chemo-immunotherapy as a novel treatment paradigm in malignant pleural mesothelioma

Cited by 21 publications

References 44 publications

Polymeric films loaded with cisplatin for malignant pleural mesothelioma: a pharmacokinetic study in an ovine model

Polymeric films loaded with cisplatin for malignant pleural mesothelioma: a pharmacokinetic study in an ovine model

New Perspectives on Diagnosis and Therapy of Malignant Pleural Mesothelioma

Heterogeneous Contributing Factors in MPM Disease Development and Progression: Biological Advances and Clinical Implications

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